Opinion piece from OHC on Save Public Medicare

By: Natalie Mehra and Michael McBane
Published on Mon. July 8, 2013

Summer’s here and the deepest thought most of us hope to have is what to barbecue. It is not generally a time when significant moments in our politics and society are expected to occur. But provincial and territorial Premiers from across Canada will gather in Niagara-on-the-Lake July 24-26 for the Council of the Federation meetings. This gathering offers a window of opportunity to raise an issue vital to the lives of all Canadians.

This summer’s gathering of the premiers marks the final Council of the Federation meeting before 2014, when the National Health Accord expires. Penned in 2004, the 10-year health accord set priorities to improve access to health care and established a new funding formula.

The meetings do not include the federal government and Prime Minister Stephen Harper will not be in Niagara. What many Canadians do not realize is that there are no first ministers’ gatherings of all the premiers and the prime minister anymore. Harper refuses to attend them.

The 2004 health accord’s funding formula effectively reversed the cuts of the 1990s. It has helped to stabilize our health-care system, improve access and increase the federal share of health-care funding. But virtually all of the other initiatives set out by the first ministers in the accord have since been abandoned by the Harper Conservative government.

Wait times have received the most attention by the media, but progress is widely variable across the country. Dramatic increases in the number of diagnostic tests and significant progress in reducing wait times for surgeries in provinces like Ontario have not been matched by other provinces. While tracking and managing wait times in several provinces has improved, there is still a long way to go.

Equally important, in 2004 the provinces, territories and federal government established a National Pharmaceutical Strategy. Finally, progress was promised toward a national drug coverage program that would actually cut overall drug costs through bulk buying and better co-ordination. But since their election, the Harper Conservative government has refused to participate in this committee, effectively killing the dream of national drug coverage and stalling progress on reducing drug prices for the better part of the last decade.

In 2004, out of the health accord discussions, the provinces and federal government also began work to discuss home and continuing care. Progress on creating a national home and continuing care strategy is vital for more than a million Canadians who struggle with high out-of-pocket costs for post-hospital care.

When the Canada Health Act was written, hospitals cared for the ill and nursing homes and home care cared for the frail. This has changed. In Ontario alone, 18,500 hospital beds have been closed since 1990, cutting our acute and chronic care hospital bed capacity in half. Patients with complex and heavy care needs are now discharged from hospitals into nursing homes and home care. As health care is changing, the commitment of Canadians to health care based on need not wealth remains strong. But our legislation has not kept up.

The Canada Health Act covers medically necessary hospital and physician services. When patients are moved out of hospital, they are no longer protected by single-tier public medicare. They are forced to pay for their own drugs. They face long waits, poor access and user fees for home care, rehabilitation and long-term care. Too often, these public services have been privatized to for-profit companies that maximize user fees in order to maximize their profit margins.

A national strategy to re-establish coverage for those services is crucial to ensure that when patients are moved out of hospital they are not moved out from under the umbrella of public health-care coverage. The Harper government has done nothing to expand the principles of medicare to cover home and continuing care.

In fact, the federal Conservative government’s antipathy to public medicare is becoming more and more overt. Not only has it walked away from the table on a national drug program and home care, it has also bluntly refused to meet with the provincial governments about renewing the funding formula for health care. Instead, the federal government plans to reduce funding from current projections by $36 billion in upcoming years, reversing the gains made in the health accord. In the latest budget, the government cut the Health Council of Canada as well as health services for veterans and refugees. The federal health minister has done nothing to implement the National Mental Health Strategy and has taken no action to uphold single-tier medicare in the face of private clinics extra-billing patients in provinces like British Columbia.

This summer, the health-care debate will heat up as health coalitions from across Canada are mobilizing thousands of Canadians to attend rallies and a shadow summit at the Council of the Federation meetings in Niagara-on-the-Lake. If they allow the expiration of the health accord to go by without comment, the provincial and territorial premiers will be missing a key window of opportunity to take a stand for public medicare. Canadians need to know what is at stake and the premiers have an occasion to spell it out. The prime minister should get back to the table. Canadians of all political stripes support the core values of public medicare and expect strong federal leadership to uphold it.

Natalie Mehra is director of the Ontario Health Coalition. Michael McBane is national co-ordinator of the Canadian Health Coalition.